Clinical Passport Tutorial

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What is a Clinical Passport?

The Clinical Passport is a set of established health and safety standards required of all students and faculty caring for patients in the healthcare

setting. It serves as a record of immunity status for vaccine-preventable diseases. The record should show all pertinent information about that vaccine and when it was administered. Why are vaccinations important? You are likely to come into contact with infective material from patients, potentially placing you at risk for exposure and possible transmission of vaccine-preventable diseases. Why is the Clinical Passport so important? Employers and healthcare providers have a

shared responsibility to prevent occupationally

acquired infections and avoid causing harm to patients by taking reasonable precautions to prevent transmission of vaccine-preventable diseases. Vaccines help maintain immunity and safeguards you and other healthcare professionals from infection and the potential or patients becoming infected. Keeping Current You have the professional responsibility to know and keep current with your immunizations and health requirements.

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TUBERCULIN STATUS There are two types of tests that are done to measure for TB exposure:

• Tuberculin Skin Test (TST) • TB blood tests (IGRA)

TST: When you first have a TST, you are required to get a 2-step. The first skin test reaction should be read between 48 and 72 hours after administration. You will have to retest if not read within this time period. If the first TST is negative, you will need to obtain a second TST within 1-3 weeks, then yearly after that. If your yearly TST lapses, you will then need to again complete the 2-step process.

Rationale – A 2-step is performed at baseline because people who were infected with TB many years ago may have a negative reaction to an initial TST. The first “step” may stimulate (or boost) the immune system’s ability to react to the test. If the second “step” is not

performed as part of baseline screening, a subsequent positive TST reaction could be misinterpreted as a new infection. Additionally, the TST (Tuberculin Skin Test) and a live vaccine must be done on the same day or separated by 30 days. If done sooner, there is potential for a false positive, resulting in increased cost and unnecessary treatment (chest x-rays). TB Blood Tests - Interferon Gamma Release Assays (IGRAs) are blood tests for detection of infection to M. tuberculosis. The IGRA measures the person’s immune reactivity to M. tuberculosis, the bacterium that causes TB. The IGRA tests most commonly available are the QuantiFERON Gold In-Tube (QFT-IT) and TSPOT tests.

Note: If you have a newly positive TST or TB Blood Test you will require a follow-up by your healthcare provider (chest X-ray, symptoms check and possible treatment documentation of absence of active M. TB disease). You will also need to complete a health questionnaire.

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HEPATITIS B Complete a series of three vaccines at 0, 1, and 6 months and a post vaccination titer at 6 and 8 weeks after the series… or

• Provide documentation of positive titer (anti-HBs or HepB Sab)… or

• Provide documentation of history of Hepatitis B… or

• Furnish a signed declination. Note: Many healthcare organizations do not accept a declination.

MMR

You are required to have 2 MMR vaccines or proof of titer (3 titers, one each of Measles [Rubeola], Mumps and Rubella). NOTE: In most cases getting the MMR is far less expensive than having blood

titers drawn. Revaccination with MMR is safe. Varicella You are required to have 2 Varicella vaccines or proof of titer. NOTE: The titer is only recommended if you have had chicken pox disease. Titer after Varicella vaccine is not recommended by the CDC as most Varicella tests are not sensitive enough to detect antibody level for immunity post vaccination.

Tetanus

Students and faculty are required to show proof of one dose of Tdap, administered after 18 years of age, and a

routine Td booster every 10 years.

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Influenza Students and faculty are required to show:

• Proof of seasonal vaccine (either the flu shot or nasal spray flu vaccine and where administered [pharmacy, personal medical provider, etc.])… or

• Signed declination of vaccination. NOTE: Some healthcare institutions require vaccination without exception. Others may allow you to decline on a basis of medical condition, religious belief or creed, or on the basis of a strongly held personal belief. That requires your signature on a declination form stating the reason for declining and committing to wear a mask at all times during flu season when in the institution.

Keep in mind that all l ive vaccines, such as MMR, Varicella, LAIV (nasal flu) have to be administered on the same day or separated by 28 days.

Expiration - If any of your immunizations expire in the middle of the quarter or semester, up-to-date immunizations are required before beginning the term.

Authorization for Release of Record

Healthcare organizations conduct random compliance audits of student and faculty health and safety requirements. At any time, healthcare has the authority to request proof of a student’s and faculty’s Clinical Passport information.

Your education program will ask you to sign a form which authorizes the college to release this information to any healthcare organization which provides the student’s clinical training experience. This includes all necessary background check information (including, but not limited to: National criminal background check, Washington State Patrol background check, OIG and GSA Excluded Providers database search), and immunization records to any affiliated clinical education site requesting such information in order to finalize your externship placement with those facilities.

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CPR

You are required to complete an American Heart Association (AHA) BLS course. The BLS Course teaches both single-rescuer and team basic life support skills for application in both in- and out-of-hospital settings. The course trains participants to promptly recognize several life-threatening emergencies, give high-quality chest compressions, deliver appropriate ventilations, and provide early use of an AED. It includes adult, child, and infant rescue techniques. NOTE: Course can be AHA BLS Provider or Military Health Network Course. “Heartsaver CPR is not acceptable for this requirement.” Background Checks

Thorough Criminal Background Checks are performed upon admission and reentry/rehire to a program. Checks are repeated annually.

Healthcare partners reserve the right to refuse or accept any student on the basis of these checks.

Licensure If any individual possesses a healthcare license, certification or registration, this information must be provided including State of issue and expiration date.

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Insurance

Professional Liability insurance policy with a $1,000,000/3,000,000 limit is required. A policy expiration date must be provided. NOTE: Some healthcare organizations may have additional requirements that are listed at the bottom of your Passport. Your education program will inform you if any of these requirements will be necessary.